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1. (WO2019028458) VERESS-TYPE NEEDLES WITH ILLUMINATED GUIDANCE AND SAFETY FEATURES
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CLAIMS

What is claimed is:

1. An apparatus comprising:

a handle having proximal end and distal end connected at the distal end to a hollow distally extending needle having a distal end for penetrating tissue and a proximal end, wherein the handle and hollow distally extending needle form a conduit for passing at least one of fluid or instruments therethrough;

a visualization stylet having a proximal end and a distal end, said visualization stylet being slidably disposed within the conduit, wherein a distal end region of the visualization stylet includes an electronic photodetector chip mounted thereon having a distally facing surface configured to detect incoming light traveling along a proximal direction, the visualization stylet further including a light source configured to project light beyond the electronic photodetector chip in a distal direction to provide direct illumination, wherein light originating from the light source is reflected back to the electronic photodetector chip when the apparatus is traveling through tissue; and

a spring housed within the handle for biasing the visualization stylet to extend past the sharp distal end of the hollow distally extending needle absent resistance by tissue against the visualization stylet.

2. The apparatus of Claim 1, wherein the visualization stylet includes a lens element disposed on a distal tip thereof over the electronic photodetector chip.

3. The apparatus of Claim 2, wherein the lens element directly contacts the electronic photodetector chip.

4. The apparatus of Claim 2, wherein the lens element is axially spaced with respect to the electronic photodetector chip.

5. The apparatus of Claim 2, wherein the lens element directly is adjustably axially spaced with respect to the electronic photodetector chip to permit a user to focus incoming light passing through the lens onto the electronic photodetector chip.

6. The apparatus of Claim 5, wherein axial spacing of the lens element from the electronic photodetector chip along a central longitudinal axis of the apparatus is adjusted by sliding the lens element with respect to the electronic photodetector chip.

7. The apparatus of Claim 5, wherein axial spacing of the lens element from the electronic photodetector chip along a central longitudinal axis of the apparatus is adjusted by rotating the lens element with respect to the electronic photodetector chip.

8. The apparatus of Claim 2, wherein the lens element includes a convex lens.

9. The apparatus of Claim 2, wherein the lens element includes a plano-convex lens.

10. The apparatus of Claim 2, wherein the lens element is conically shaped.

11. The apparatus of Claim 2, wherein the lens element is pyramid-shaped.

12. The apparatus of Claim 2, wherein the lens element is dome shaped.

13. The apparatus of Claim 2, wherein the lens element includes a central lens configured to focus incoming light on the electronic photodetector chip surrounded by a plurality of secondary lenses configured and arranged to disperse light transmitted distally from the lens element originating from the light source.

14. The apparatus of Claim 13, wherein the light source includes a bundle of fiber optic elements coupled to a source of light.

15. The apparatus of Claim 13, wherein the light source includes at least one micro-LED element surrounding the electronic photodetector chip.

16. The apparatus of Claim 15, wherein said at least one micro-LED element includes an optic disposed thereon that focuses and directs light from the at least one micro-LED element onto at least one of the secondary lenses.

17. The apparatus of Claim 2, wherein the lens element includes a central lens configured to focus incoming light on the electronic photodetector chip surrounded by an annular region of the lens, wherein the central lens is radially separated from the annular region of the lens by at least one fluid flow channel configured and arranged to direct a jet of cleaning fluid over at least a portion of the central lens.

18. The apparatus of Claim 17, wherein the central lens and the annular region of the lens are integrally molded.

19. The apparatus of Claim 17, wherein the central lens and the annular region of the lens are formed from at least two discrete components.

20. The apparatus of Claim 2, further comprising at least one fluid flow channel configured and arranged to direct a jet of cleaning fluid over at least a portion of a central lens disposed at the distal end of the visualization stylet.

21. The apparatus of Claim 20, wherein said at least one fluid flow channel is defined by a tubular member slidably disposed along the visualization stylet, said tubular member defining a plurality of spray openings in a side wall thereof.

22. The apparatus of Claim 21, wherein said tubular member is formed from a shape memory material, and further wherein when a distal region is advanced distally out from the visualization stylet, it takes on a heat set curvature that causes the tubular member to bend toward the lens element.

23. The apparatus of Claim 5, wherein axial spacing of the lens element from the electronic photodetector chip is adjusted by actuating an actuator near a proximal end of the visualization stylet.

24. The apparatus of Claim 2, wherein the lens element includes at least one vent hole therein.

25. The apparatus of Claim 20, wherein said at least one fluid flow channel is defined by at least one tubular member attached to an inner wall of said conduit, and further wherein said tubular member defining a plurality of spray openings in a side wall thereof configured and arranged to clean the lens by directing a transverse flow of fluid across the lens.

26. The apparatus of Claim 1, wherein the visualization stylet defines at least one elongate insufflation conduit therein configured to pass insufflation gas therethrough to a distal end region of the apparatus.

27. The apparatus of Claim 26, wherein insufflation gas exits through at least one opening defined through a sidewall of the visualization stylet near a distal tip of the visualization stylet.

28. The apparatus of Claim 1, wherein the visualization stylet is formed at least in part from a light transmitting material.

29. The apparatus of Claim 1, wherein the light source includes at least one LED disposed in the proximal end of the handle.

30. The apparatus of Claim 1, further comprising a gas introduction port for receiving insufflation gas from a gas source.

31. The apparatus of Claim 1, wherein the visualization stylet is configured to be withdrawn proximally to establish a flow path for insufflation gas to pass through the apparatus.

32. The apparatus of Claim 1, wherein the visualization stylet further includes a conductor for directing signals received from the electronic photodetector chip to a processor.

33. The apparatus of Claim 32, wherein the processor is attached to the visualization stylet.

34. The apparatus of Claim 33, further comprising a display screen for displaying images captured by the electronic photodetector chip.

35. The apparatus of Claim 34, further comprising a battery for powering the electronic photodetector chip, processor and display screen.

36. A method of using an apparatus according to Claim 1, comprising:

creating a small superficial incision in skin of an abdomen of a subject;

advancing a distal end of the hollow distally extending needle including the visualization stylet disposed therein through successive layers of an abdominal wall of the subject while viewing tissue being advanced through by way of the visualization stylet in real time, the visualization stylet being configured to view in a distal direction; and

stopping advancing the distal end of the hollow distally extending needle upon observing the visualization stylet extending distally with respect to the hollow distally extending needle indicating that an abdominal cavity of the subject has been reached.

37. A method as recited in Claim 36, further comprising commencing insufflation through the hollow distally extending needle after stopping advancing the distal end of the hollow distally extending needle.

38. A method as recited in Claim 37, wherein commencing insufflation through the hollow distally extending needle further includes removing the visualization stylet through the proximal end of the hollow distally extending needle and injecting gas through the hollow distally extending needle.

39. A method as recited in Claim 36, further comprising directing signals from the electronic photodetector chip to a processor.

40. A method as recited in Claim 39, further comprising directing signals from the processor to a display screen.

41. The method of Claim 36, wherein the hollow distally extending needle acts as a sheath that at least partially covers the visualization stylet along its length, and further wherein the handle includes a cannula that is removably attached to the hollow distally extending needle, wherein the method further comprises, after insufflation, removing the cannula from the hollow distally extending needle and withdrawing the cannula proximally over the visualization stylet.

42. The method of Claim 41, wherein removing the cannula includes disconnecting a threaded connection joining the hollow distally extending needle and the cannula.

43. The method of Claim 41, further comprising attaching a proximal extension to at least one of the hollow distally extending needle and the visualization stylet to form an assembly, and performing a laparoscopic procedure using the assembly as an endoscope.

44. The method of Claim 36, further comprising separating hollow distally extending needle and handle from the visualization stylet and removing one of the visualization stylet and hollow distally extending needle and handle from the subject.

45. The method of Claim 44, wherein the visualization stylet is removed, leaving the hollow distally extending needle in place to function as a cannula for performing a further procedure.

46. The method of Claim 45, further comprising removing a lens cap from the visualization stylet, and reintroducing the visualization stylet into the handle and the hollow distally extending needle without the lens cap.

47. The method of Claim 36, further comprising removing a lens cap from a distal end of the visualization stylet.

48. The method of Claim 47, wherein the lens cap is removed by articulating the lens cap away from the distal end of the visualization stylet on a hinge.

49. The method of Claim 36, further comprising directing a cleaning fluid including at least one of a liquid or gas at least partly in a transverse direction across the distal end of the visualization stylet while inside the subject to enhance visualization.

50. The method of Claim 36, wherein directing a cleaning fluid includes distally extending a cleaning wand that is configured and adapted to direct cleaning fluid toward the distal end of the visualization stylet.

51. The method of Claim 50, wherein directing the cleaning fluid includes directing the cleaning fluid through the visualization stylet and out through at least one opening at the distal end region of the visualization stylet.

52. The method of Claim 51 , wherein directing the cleaning fluid includes directing the cleaning fluid through a lens located at the distal end of the visualization stylet.

53. The method of Claim 52, wherein the cleaning fluid is directed at least partially along a radially inward path across a central region of the lens.

54. The method of Claim 50, wherein directing the cleaning fluid includes directing the cleaning fluid through the hollow distally extending needle.

55. The method of Claim 54, wherein directing the cleaning fluid includes directing the cleaning fluid through at least one tubular passage disposed between the visualization stylet and an inner bore of the hollow distally extending needle, wherein the at least one tubular passage is attached to the inner bore of the hollow distally extending needle.

56. The method of Claim 44, removing the hollow distally extending needle and handle, leaving the visualization stylet in place.

57. The method of Claim 56, further comprising adding a proximal extension to the visualization stylet to form an assembly, and using the assembly as an endoscope.

58. The method of Claim 56, further comprising disposing a cannula having a bore diameter at least twice the diameter of the visualization stylet over the visualization stylet, causing the tissue to dilate radially outwardly.

59. The method of Claim 58, wherein the visualization stylet has a diameter of 1 to 2mm, and further wherein the cannula has a 5mm bore.

60. The method of Claim 58, wherein the visualization stylet has a diameter of 1 to 2mm, and further wherein the cannula has a 10mm bore.

61. The method of Claim 58, further comprising withdrawing the visualization stylet, leaving the cannula in place.

62. The method of Claim 61, further comprising introducing a further instrument through the cannula.

63. The method of Claim 62, wherein the further instrument is an endoscope configured to match a size of a bore of the cannula.

64. The method of Claim 49, wherein the fluid is caused to follow a curvature across the distal end of the visualization stylet at least in part due to a Coanda effect.